| PTO Form 2197 (Rev 09/2005) |
| OMB No. 0651-0056 (Exp 09/30/2011) |
| Input Field | Entered |
|---|---|
| SERIAL NUMBER | 77771264 |
| MARK SECTION | |
| MARK | OCTAVE |
| OWNER SECTION (current) | |
| NAME | BlueCross BlueShield of Tennessee, Inc. |
| STREET | 801 Pine Street |
| CITY | Chattanooga |
| STATE | Tennessee |
| ZIP/POSTAL CODE | 37402 |
| COUNTRY | United States |
| CORRESPONDENCE SECTION (current) | |
| ORIGINAL ADDRESS | ROBERT P. FELBER, JR. WALLER LANSDEN DORTCH & DAVIS, LLP 511 UNION ST STE 2700 NASHVILLE Tennessee 37219-1791 United States 615-850-8741 615-244-6804 rfelber@wallerlaw.com |
| NEW OWNER ADDRESS | |
| STREET | 1 Cameron Hill Circle |
| CITY | Chattanooga |
| STATE | Tennessee |
| ZIP/POSTAL CODE | 37402 |
| COUNTRY | United States |
| CURRENT CORRESPONDENCE ADDRESS | |
| NAME | Robert P. Felber, Jr. |
| FIRM NAME | Waller Lansden Dortch & Davis, LLP |
| INTERNAL ADDRESS | Suite 2700 |
| STREET | 511 Union Street |
| CITY | Nashville |
| STATE | Tennessee |
| COUNTRY | United States |
| POSTAL/ZIP CODE | 37219 |
| PHONE | 615-850-8741 |
| FAX | 615-244-6804 |
| SIGNATURE SECTION | |
| SIGNATURE | /Robert P. Felber, Jr./ |
| SIGNATORY NAME | Robert P. Felber, Jr. |
| SIGNATORY DATE | 08/18/2009 |
| SIGNATORY POSITION | Attorney of record, Tennessee bar member |
| FILING INFORMATION SECTION | |
| SUBMIT DATE | Tue Aug 18 17:41:24 EDT 2009 |
| TEAS STAMP | USPTO/COA-XXX.XXX.XXX.XXX -20090818174124051148-763 84301-40081df10e543d1e0d0 c13b10a83e11cc-N/A-N/A-20 090818164603471628 |